Table 2.
Study characteristics for multi-component interventionsa
| Study | Participants | Design/Type of Control | Intervention/Nature of ISG | Outcome Measures/ Follow-Up | ITT | Completer No. and % Dropout (d/o) | Results/Effect Sizeb | Significant? | |
| Cancer | |||||||||
| Owen 2003 [22] USA |
N = 59 women with BC I = 29; C = 30 Recruitment: Contact with patients in medical oncology clinics, advertisements in hematology/oncology outpatient clinic, health websites, community nurse referral, media $10 for completing each survey |
RCT/WLC Randomization: Random number generator |
12-wk SURVIVE online program comprising health professional, moderated bulletin board group, cancer information, resources, self-management advice, art/poetry forum, structured coping skills exercises (including stress management, assertiveness, and structured problem solving training) Up to 20 participants per group |
HADS Baseline 12 wks |
No | I = 25 (13.8% d/o) C = 27 (10% d/o) |
NS difference in baseline adjusted mean at 12 wks for intervention and control groups | No | |
| Van Den Brink 2007 [23] Netherlands |
N = 184 people post-surgery for head or neck cancer I = 39; C = 145 Recruitment: Tertiary university hospital–treated patients recruited by doctor independent of treating physicians |
CT/TAU | 6-wk electronic health information support system comprising peer-to-peer forum and email communication; information and monitoring via electronic questionnaire | “Feelings of depression” Baseline 6 wks 3 mths |
No | N = 163 (11.4% d/o) I = 35 (10.3% d/o) C = 128 (11.7% d/o) |
NS baseline adjusted difference in change at 6 or 3 mths for intervention compared to control groups | No | |
| Neurological | |||||||||
| Brennan 1995 [44] USA |
N = 102 caregivers of people with Alzheimer’s disease I = 51; C = 51 Recruitment: Research registry, support groups |
RCT/TAU Randomization: Not specified |
12-mth access to bulletin board moderated by nurse who posted messages to “foster systematic group cohesion” and information and decision support (expert Q&A) | CES-D Baseline 12 mths (intervening variable) |
No | I = 47 (7.8%c d/o) C = 49 (3.9% d/o) |
Depression was treated as a intervening variable rather than an outcome ES = 0.24 |
N/R | |
| Liebermann 2005d [28,45] USA |
N = 66 or 65 patients with PD assigned to: Heterogeneous (Het) groups - variable age and time since diagnosis Homogenous (Hom) groups - homogenous age and time since diagnosisd Recruitment: Fliers to support groups, PD clinic, practitioners, online posts, newsletter |
Pre-post | 20 wks × 1.5 hrs weekly health-professional moderated chatroom and bulletin board available at all times and Q&A weekly health education session with an expert | CES-D Baseline 20 weeks |
No | Dropout rates could not be calculated separately for Hom and Het Combined: I = 32 (39% d/o)d NS differences in baseline measures between dropouts and completers |
Significant reduction in depressive symptoms following intervention involving Hom but not Het ISGd |
Hom: Yes Het: No |
|
| Chronic Illness | |||||||||
| Battles [46] USA |
N = 32 children (age 8-19 yrs) with serious chronic illness (HIV, cancer, granuloma, neurofibromatosis) participating as residential out patients in pediatric clinical trials at the NIH Recruitment: Playroom staff at NIH residential center identified potentially eligible participants Researchers approached eligible participants/parents |
(1) Restricted randomly alternating (A, B) treatment design Control = normal playroom activity (2) Pre-post |
4 × 30 min sessions on the STARBRIGHT World (SBW) program comprising network connection to other children in a hospital (video) Connect/Find a Friend and information about medical conditions and entertainment and distraction Sessions administered across multiple NIH residential visits over unspecified time period |
Depression Analogue Scale CBCL-anxious depressed (parent) Usefulness in reducing sadness-depression (parent) Pre-post session Pre-post intervention |
d/k |
d/k |
NS improvement in depression ratings or symptoms 24% parents reported positive effects of the program on mood Estimated ES (CBCL) = −0.06 |
No |
|
| Hill 2006 [47] USA |
N = 120 female, rural residents (35 to 65 yrs) with chronic illness (diabetes/rheumatoid condition/ heart condition/multiple sclerosis/cancer) I = 61; C = 59 Recruitment: Mass media, agency and service organization newsletter, and word of mouth |
RCTd Randomization: Method not specified | 22-wk professionally moderated online support group and online health information modules The support group was described as an “asynchronous chatroom” |
CES-D Baseline 22 wks |
No | I = 43 (29.5% d/o) C = 57 (3.4% d/o) |
NS differences in reduction in depressive symptoms in intervention compared to the control group ES = 0.15 |
No | |
| Carers | |||||||||
| Bragadottir 2004 [26] USA thesis, Icelandic sample |
N = 21 parents of children who had completed cancer treatment within past 5 yrs Mothers: I = 11 Fathers: I = 10 Recruitment: From files of Icelandic hospital responsible for treating children with cancer |
Pre-post | 4-mth access to health professional–moderated mailing list Professionals facilitated and joined in group discussions, answered questions, directed parents to resources, corrected misconceptions/misinformation, monitored appropriateness of discussions |
SCL-90 depression subscale Baseline 3 mths 4 mths |
No | 3 mths and 4 mths N= 16 (23.8% d/o) Mothers: I = 8 (27.3% d/o) Fathers: I = 8 (20% d/o) |
Mothers: NS reduction in depressive symptoms ES = −0.10 (3 mths) ES = 0.20 (4 mths) Fathers: NS reduction depressive symptoms ES = −0.22 (3 mths) ES = 0.40 (4 mths) |
Mothers: No Fathers: No |
|
| Carers andHeart Recipients | |||||||||
| Dew 2004 [21] USA |
N = 124 heart recipients and family caregivers Recipients: I = 24; C = 40 Caregivers: I = 20; C = 40 Recruitment: Letter from transplant team asking if had Internet access Those with access “approached” to participate |
Controlled/ “Historic” TAU comparison group enrolled in other longitudinal studies and matched for demographic distribution and assembled before or after intervention | 4-mth HeartNet programs comprising discussion groups (online moderated bulletin boards, separate caregiver and recipient boards) and interactive online stress and medical regimen management skills training grounded in CBT principles and Ask an Expert (online questions to transplant team expert plus Q&A Library plus archived responses to Ask and Expert plus Health living tips plus Resources plus References Library) | SCL-90 Depression subscale Baseline, 4 mths (I), and 4-6 mths (C) |
No |
Recipients: I= 20 (16.7% d/o) C = 34 (15% d/o) Caregivers: I= 17 (15% d/o) C = 34 (15% d/o) |
Recipients: Receiving intervention showed a greater reduction in depressive symptoms than the control group Caregivers: NS difference in reduction in depressive symptoms in intervention compared to the control group | Recipients:Yes Caregivers: No |
|
| Diabetes | |||||||||
| McKay 2001 [48] USA |
N = 78 sedentary people with type 2 diabetes aged 40 years or older I = 38; C = 40 Recruitment: Email postings to online diabetes groups and websites |
RCT /online information, blood glucose tracking Control Randomization: Automatic system allocated |
8-wk D-Net Active Lives program comprising tailored online physical activity program with tracking of daily physical activity, information about a physical activity plus online personal coach counseling plus health professional moderated online peer support (Active Lives Support Group) | CES-D Baseline 8 wks |
No | N = 68 (13% d/o) I = 35 (7.9% d/o) C = 33 (17.5% d/o) Predictors of drop out: None |
NS difference in reduction in depressive symptoms in intervention compared to control group ES = 0.35 |
No (P = .10) |
|
| HIV | |||||||||
| Gustafson 1994 [49] USA Gustafson 1999 [24] USA |
N = 219; I = 118; C = 97 with HIV 3-mth intervention: I = not specified; C = not specified 6-mth intervention: I = not specified; C = not specified Recruitment: Posters, newspaper advertisement, HIV clinics/organizations Paid to complete surveys |
RCT/TAU Randomization: Independent third party using random number table |
6 mths (Cohort 1) and 3 mths (Cohorts 2 and 3) CHESS program comprising online facilitated bulletin board discussion group plus Q&A plus Instant Library (information articles) plus Ask an Expert (communication with medical experts) plus Getting help/support plus Referral Directory plus Personal stories plus assessment (of lifestyle risks) plus Decision Aid plus Action Plan for implementing decisions |
MOSdepression subscale 3-mth Int: Baseline, 2 mths, 5 mths 6-mth Int: Baseline, 2 mths, 5 mths, 9 mths |
No | Dropout rates could not be calculated separately for 3-mth and 6-mth intervention groups All cohorts at 2 mths: I = 97 (17.7% d/o) C = 90 (9.3% d/o) All cohorts who “completed trial”: I = 94 (21% d/o) C = 89 (9.2% d/o) |
NS differences in reduction in depressive symptoms in intervention compared to control group for any follow-up/cohort combination | 3-mth Int (5-mth f/up): No 6-mth Int (9-mth f/up): No |
|
| MentalDisorder | |||||||||
| Taylor 2006 [50] USA |
N = 480 college women (18 to 30 yrs) at high risk of developing an eating disorder I = 244; C = 236 Recruitment: Flyers at colleges, campus mailings, mass media |
RCT/WLC Randomization: Stratified by school; computer-generated sequences produced by study coordinator |
8-wk professionally modified bulletin board and cognitive behavioral intervention |
CES-D Baseline 8 weeks 60 weeks |
No |
I = 191 (21.7% d/o)e C = 198 (16.1% d/o)e NS demographic or baseline differences between completers and non-completers |
NS difference in reduction in depressive symptoms in intervention compared to control group ES = 0.04 (8 wks) ES = 0.11 (60 wks) |
No (P < .07) |
|
| IVF | |||||||||
| Tuil 2006 [25] Netherlands |
N = 244 participants undergoing IVF or ICSI treatment in authors’ hospital Males: I = 61; C = 61 Females: I = 61; C = 61 Recruitment: From author IVF clinic |
RCT “Randomization”: Alternating allocation to intervention or control |
Access to professionally moderated bulletin board and chatroom (for communication with peers and professionals) plus information and access to own records during period of IVF/ICSI treatment cycle | Beck Depression Index for Primary Care Baseline Post-intervention |
No | Males: I= 51 (16.4% d/o) C = 38 (37.7% d/o) Females: I= 51 (16.4% d/o) C = 40 (34.4% d/o) |
Males: ES = −0.25 Females: ES = 0.18 |
Males: No Females: No |
|
a BC = breast cancer; C = control sample size; CBCL = Child Behavior Checklist; CBT = cognitive behavioral therapy; CES-D = Center for Epidemiologic Studies Depression Scale; CT = controlled trial; d/k – don’t know; ES = effect size; HADS = Hospital Anxiety & Depression Scale; I = intervention sample size; ITT = intent to treat; MOS = Medical Outcomes Study; NIH = National Institutes of Health; N/R = not reported; PD = Parkinson’s disease; RCT = randomized controlled trial; SCL-90 = Symptom Checklist 90; TAU = treatment as usual; WLC = wait list control.
b Pre-post standardized effect size (for pre-post design) or difference between intervention and control pre-post effect sizes (for controlled designs).
c Includes three (5.9%) dropouts “not able to have computer installed.”
d Due to apparent inconsistencies within and between the two papers on this study, effect sizes have not been computed, individual sample sizes are not reported, and individual dropout rates not computed.
e Computed for completers of CES-D only; data for overall completers not available.